Vertigo is the feeling that you or your environment is moving or spinning. It differs from dizziness in that vertigo describes an illusion of movement where there is a feeling of movement when one is stationary. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving is called objective vertigo. Vertigo is thought to be caused by problems in the brain or in the inner ear.
With vertigo there is a sensation of motion either of the person or the environment, often perceived as if the room is spinning around you. This should not be confused with symptoms of lightheadedness or fainting. Vertigo differs from motion sickness in that motion sickness is a feeling of being off-balance and lacking equilibrium, caused by repeated motions such as riding in a car or boat. Symptoms include a sensation of disorientation or motion. In addition, the individual may also have one or more of the following symptoms; nausea or vomiting, sweating and/or abnormal eye movements.
The duration of symptoms can be from minutes to hours, and symptoms can be constant or episodic. The onset may be due to a movement or change in position, head trauma or whiplash injury as well as any new medications the affected individual is taking. A person may have hearing loss and a ringing sensation in the ears or visual disturbances, weakness, difficulty speaking, a decreased level of consciousness, and difficulty walking.
Vertigo may be caused by a number of internal or external factors. For example, the most common form of vertigo is benign paroxysmal positional vertigo (BPPV, characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction.
Vertigo may also be caused by inflammation within the inner ear (labyrinthitis or vestibular neuritis), which is characterized by the sudden onset of vertigo and may be associated with hearing loss. The most common cause of labyrinthitis is a viral or bacterial inner ear infection. Otoliths (stones) in the ear canals can also cause vertigo.
Meniere's disease is a disorder of the inner ear composed of a triad of symptoms including: episodes of vertigo, ringing in the ears (tinnitus), and hearing loss. People with this condition have an abrupt onset of severe vertigo, fluctuating hearing loss, as well as periods in which they are symptom-free.
Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose. Head trauma, neck injury and concussions may also result in vertigo.
Migraine-associated vertigo (MAV) or vertiginous migraine is a recognized disease condition consisting of dizziness and/or vertigo. Other terms used to describe this condition include vestibular migraine, migrainous vertigo, or migraine-related vestibulopathy. While thought to be related to migraine headache, patients diagnosed with MAV and the like do not have classic migraine headaches, or have chronic non-specific headaches that do not fit into the migraine classification developed by the International Headache Society.
Persons with MAV often describe chronic dizziness and disequilibrium in the form of a “rocking” sensation. Sometimes the vertiginous effects are described as episodes of rotational vertigo, changes in vision, visual “snow”, nausea and severe motion intolerance. Neurological examinations (including neuroimaging) are often completely normal. Patients with chronic dizziness often do not experience acute rotational vertigo or even the pain of a migraine headache.
Commonly prescribed medications for vertigo include meclizine hydrochloride (Antivert), diphenhydramine (Benadryl), scopolamine transdermal patch (Transderm-Scop) and promethazine hydrochloride (Phenergan).